Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of scaling and root planing with and without adjunct Nd:YAG laser therapy on glucose control and periodontal microecological imbalance in periodontitis patients with type 2 diabetes mellitus: a randomized controlled trial

  • Research
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

The study aims to determine the effects of Nd:YAG laser-assisted with subgingival scaling and root planing (SRP) treatment on glucose control and the dynamic changes of subgingival microbiome in periodontitis with type 2 diabetes mellitus (T2DM).

Materials and methods

Twenty-two patients were split into Nd:YAG group (n = 11) and SRP group (n = 11). Patients in the Nd:YAG group received SRP and auxiliary Nd:YAG laser treatment; patients in the SRP group received SRP treatment only. Periodontal tissue inflammation and glycemic control were assessed and analyzed during the treatment period and the changes of subgingival microbiome were analyzed by full-length 16S rRNA sequencing.

Results

After 3 months of treatment, PD and CAL values improved significantly in the Nd:YAG group compared to the SRP group. BOP in both groups improved significantly after treatment. FPG levels in the Nd:YAG group were significantly reduced after treatment. Porphyromonas and Porphyromonadaceae were enriched in the Nd:YAG group at baseline, and Fusobacteriota, Fusobacteriia, Fusobacteriales, Leptotrichiaceae, and Leptotrichia were enriched after treatment.

Conclusion

Nd:YAG laser-assisted SRP therapy has additional benefits in improving periodontal tissue inflammation and blood glucose control in periodontitis patients with T2DM compared with SRP therapy alone and there was a trend towards a decrease in disease-associated taxa and an increase in health-associated taxa following auxiliary Nd:YAG laser treatment.

Clinical relevance

The effects of Nd:YAG laser-assisted SRP treatment on inflammation, glucose control, and subgingival microbiome in periodontitis patients with T2DM were elucidated, and new ideas for the treatment of T2DM periodontitis were provided.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Meyle J, Chapple I (2015) Molecular aspects of the pathogenesis of periodontitis. Periodontol 2000 69(1):7–17

    Article  PubMed  Google Scholar 

  2. Pizzo G, Guiglia R, Lo Russo L, Campisi G (2010) Dentistry and internal medicine: from the focal infection theory to the periodontal medicine concept. Eur J Intern Med 21(6):496–502

    Article  PubMed  Google Scholar 

  3. Avila M, Ojcius DM, Yilmaz O (2009) The oral microbiota: living with a permanent guest. DNA Cell Biol 28(8):405–411

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Paster BJ, Olsen I, Aas JA, Dewhirst FE (2006) The breadth of bacterial diversity in the human periodontal pocket and other oral sites. Periodontol 2000 42:80–87

    Article  PubMed  Google Scholar 

  5. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15(7):539–553

    Article  PubMed  CAS  Google Scholar 

  6. Taylor GW (2001) Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodontol 6(1):99–112

    Article  PubMed  CAS  Google Scholar 

  7. Negrato CA, Tarzia O, Jovanovič L, Chinellato LE (2013) Periodontal disease and diabetes mellitus. J Appl Oral Sci 21(1):1–12

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Nascimento GG, Leite FRM, Vestergaard P, Scheutz F, López R (2018) Does diabetes increase the risk of periodontitis? A systematic review and meta-regression analysis of longitudinal prospective studies. Acta Diabetol 55(7):653–667

    Article  PubMed  Google Scholar 

  9. Lalla E, Papapanou PN (2011) Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol 7(12):738–748

    Article  PubMed  CAS  Google Scholar 

  10. Li X, Kolltveit KM, Tronstad L, Olsen I (2000) Systemic diseases caused by oral infection. Clin Microbiol Rev 13(4):547–558

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Shi B, Lux R, Klokkevold P, Chang M, Barnard E, Haake S, Li H (2020) The subgingival microbiome associated with periodontitis in type 2 diabetes mellitus. Isme J 14(2):519–530

    Article  PubMed  CAS  Google Scholar 

  12. Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, Romanos GE, Taniguchi Y, Sasaki KM, Zeredo JL, Koshy G, Coluzzi DJ, White JM, Abiko Y, Ishikawa I, Izumi Y (2015) Periodontal and peri-implant wound healing following laser therapy. Periodontol 2000 68(1):217–269

    Article  PubMed  Google Scholar 

  13. Mizutani K, Aoki A, Coluzzi D, Yukna R, Wang CY, Pavlic V, Izumi Y (2016) Lasers in minimally invasive periodontal and peri-implant therapy. Periodontol 2000 71(1):185–212

    Article  PubMed  Google Scholar 

  14. Gholami L, Asefi S, Hooshyarfard A, Sculean A, Romanos GE, Aoki A, Fekrazad R (2019) Photobiomodulation in periodontology and implant dentistry: Part 1. Photobiomodul Photomed Laser Surg 37(12):739–765

    PubMed  Google Scholar 

  15. Theodoro LH, Marcantonio RAC, Wainwright M, Garcia VG (2021) Laser in periodontal treatment: is it an effective treatment or science fiction? Braz Oral Res 35(Supp 2):e099

    Article  PubMed  Google Scholar 

  16. Laky M, Müller M, Laky B, Arslan M, Wehner C, Husejnagic S, Lettner S, Moritz A, Rausch-Fan X (2021) Short-term results of the combined application of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and erbium-doped yttrium aluminum garnet (Er:YAG) laser in the treatment of periodontal disease: a randomized controlled trial. Clin Oral Investig 25(11):6119–6126

    Article  PubMed  PubMed Central  Google Scholar 

  17. Grzech-Leśniak K, Sculean A, Gašpirc B (2018) Laser reduction of specific microorganisms in the periodontal pocket using Er:YAG and Nd:YAG lasers: a randomized controlled clinical study. Lasers Med Sci 33(7):1461–1470

    Article  PubMed  Google Scholar 

  18. Grossi SG, Genco RJ (1998) Periodontal disease and diabetes mellitus: a two-way relationship. Ann Periodontol 3(1):51–61

    Article  PubMed  CAS  Google Scholar 

  19. Genco RJ, Graziani F, Hasturk H (2020) Effects of periodontal disease on glycemic control, complications, and incidence of diabetes mellitus. Periodontol 2000 83(1):59–65

    Article  PubMed  Google Scholar 

  20. Qadri T, Poddani P, Javed F, Tunér J, Gustafsson A (2010) A short-term evaluation of Nd:YAG laser as an adjunct to scaling and root planing in the treatment of periodontal inflammation. J Periodontol 81(8):1161–1166

    Article  PubMed  CAS  Google Scholar 

  21. Qadri T, Tunér J, Gustafsson A (2015) Significance of scaling and root planing with and without adjunctive use of a water-cooled pulsed Nd:YAG laser for the treatment of periodontal inflammation. Lasers Med Sci 30(2):797–800

    Article  PubMed  Google Scholar 

  22. Eltas A, Orbak R (2012) Effect of 1,064-nm Nd:YAG laser therapy on GCF IL-1β and MMP-8 levels in patients with chronic periodontitis. Lasers Med Sci 27(3):543–550

    Article  PubMed  Google Scholar 

  23. Ezber A, Taşdemir İ, Yılmaz HE, Narin F, Sağlam M (2023) Different application procedures of Nd:YAG laser as an adjunct to scaling and root planning in smokers with stage III grade C periodontitis: a single-blind, randomized controlled trial. Ir J Med Sci 192(1):457–466

    Article  PubMed  CAS  Google Scholar 

  24. Abduljabbar T, Vohra F, Kellesarian SV, Javed F (2017) Efficacy of scaling and root planning with and without adjunct Nd:YAG laser therapy on clinical periodontal parameters and gingival crevicular fluid interleukin 1-beta and tumor necrosis factor-alpha levels among patients with periodontal disease: a prospective randomized split-mouth clinical study. J Photochem Photobiol B 169:70–74

    Article  PubMed  Google Scholar 

  25. Gómez C, Domínguez A, García-Kass AI, García-Nuñez JA (2011) Adjunctive Nd:YAG laser application in chronic periodontitis: clinical, immunological, and microbiological aspects. Lasers Med Sci 26(4):453–463

    Article  PubMed  Google Scholar 

  26. Slot DE, Kranendonk AA, Van der Reijden WA, Van Winkelhoff AJ, Rosema NA, Schulein WH, Van der Velden U, Van der Weijden FA (2011) Adjunctive effect of a water-cooled Nd:YAG laser in the treatment of chronic periodontitis. J Clin Periodontol 38(5):470–478

    Article  PubMed  Google Scholar 

  27. Pontes Andersen CC, Buschard K, Flyvbjerg A, Stoltze K, Holmstrup P (2006) Periodontitis deteriorates metabolic control in type 2 diabetic Goto-Kakizaki rats. J Periodontol 77(3):350–356

    Article  PubMed  CAS  Google Scholar 

  28. Nishimura F, Iwamoto Y, Mineshiba J, Shimizu A, Soga Y, Murayama Y (2003) Periodontal disease and diabetes mellitus: the role of tumor necrosis factor-alpha in a 2-way relationship. J Periodontol 74(1):97–102

    Article  PubMed  Google Scholar 

  29. Tsai CY, Tang CY, Tan TS, Chen KH, Liao KH, Liou ML (2018) Subgingival microbiota in individuals with severe chronic periodontitis. J Microbiol Immunol Infect 51(2):226–234

    Article  PubMed  Google Scholar 

  30. Balmasova IP, Olekhnovich EI, Klimina KM, Korenkova AA, Vakhitova MT, Babaev EA, Ovchinnikova LA, Lomakin YA, Smirnov IV, Tsarev VN, Mkrtumyan AM, Belogurov AA Jr, Gabibov AG, Ilina EN, Arutyunov SD (2021) Drift of the subgingival periodontal microbiome during chronic periodontitis in type 2 diabetes mellitus patients. Pathogens 10(5):504

  31. Ganesan SM, Joshi V, Fellows M, Dabdoub SM, Nagaraja HN, O’Donnell B, Deshpande NR, Kumar PS (2017) A tale of two risks: smoking, diabetes and the subgingival microbiome. Isme J 11(9):2075–2089

    Article  PubMed  PubMed Central  Google Scholar 

  32. Lu H, He L, Xu J, Song W, Feng X, Zhao Y, Meng H (2020) Well-maintained patients with a history of periodontitis still harbor a more dysbiotic microbiome than health. J Periodontol 91(12):1584–1594

    Article  PubMed  CAS  Google Scholar 

  33. Lu H, He L, Jin D, Zhu Y, Meng H (2022) Effect of adjunctive systemic antibiotics on microbial populations compared with scaling and root planing alone for the treatment of periodontitis: a pilot randomized clinical trial. J Periodontol 93(4):570–583

    Article  PubMed  CAS  Google Scholar 

  34. Cockburn AF, Dehlin JM, Ngan T, Crout R, Boskovic G, Denvir J, Primerano D, Plassman BL, Wu B, Cuff CF (2012) High throughput DNA sequencing to detect differences in the subgingival plaque microbiome in elderly subjects with and without dementia. Investig Genet 3(1):19

    Article  PubMed  PubMed Central  CAS  Google Scholar 

Download references

Funding

This work was supported by grants from the National Natural Science Foundation of China (82201072); the project of Jiangsu Provincial Health Commission on elderly health (LKZ2023009); the educational research project of Nanjing Medical University (2021YJS-ZD011); Jiangsu Province Capability Improvement Project through Science, Technology and Education-Jiangsu Provincial Research Hospital Cultivation Unit (YJXYYJSDW4); and Jiangsu Provincial Medical Innovation Center (CXZX202227).

Author information

Authors and Affiliations

  1. Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China

    Yifei Zhang, Pengzhou Tang, Qi Yang, Chen Li & Lu Li

  2. Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China

    Yifei Zhang, Pengzhou Tang, Qi Yang, Chen Li, Lu Li & Minxuan Han

  3. Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China

    Yifei Zhang, Pengzhou Tang, Qi Yang, Chen Li, Lu Li & Minxuan Han

  4. Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China

    Minxuan Han

Authors
  1. Yifei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pengzhou Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qi Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chen Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Minxuan Han
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Y.Z. wrote the main manuscript text. P.T., Q.Y., and C.L. were involved in the collection of clinical data. Y.Z., L.L. and M.H. participated in the analysis of the sequencing data. All authors reviewed the manuscript.

Corresponding authors

Correspondence to Lu Li or Minxuan Han.

Ethics declarations

Ethics approval and consent to participate

The study protocol and informed consent form were approved by the Institutional Ethics Committee of the Dental Hospital of Nanjing Medical University (No. (2022) 622) and written informed consent was obtained from all subjects prior to study implementation.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, Y., Tang, P., Yang, Q. et al. Efficacy of scaling and root planing with and without adjunct Nd:YAG laser therapy on glucose control and periodontal microecological imbalance in periodontitis patients with type 2 diabetes mellitus: a randomized controlled trial. Clin Oral Invest 28, 143 (2024). https://doi.org/10.1007/s00784-024-05510-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00784-024-05510-y

Keywords

Search

Navigation